联合软性和硬性输尿管镜行精囊镜检在顽固性血精诊疗中的应用  

Combining Flexible Ureteroscopy and Rigid Ureteroscopy for Trausurethral Seminal Vesiculoscopy in the Diagnosis and Treatment of Persistent Hemospermia

作　　者：孟军[1] 张志宏[1] 王义[1] 贺利军[1] 那彦群[1] 

机构地区：[1]北京大学首钢医院吴阶平泌尿外科医学中心,北京100144

出　　处：《中外医疗》2015年第21期1-3,共3页China & Foreign Medical Treatment

摘　　要：目的探讨联合应用软性和硬性输尿管镜行精囊镜检查在顽固性血精诊疗中的应用。方法回顾性分析该中心2012年6月—2014年12月间收治的23例顽固性血精患者的临床资料,完善相关检查后,联合应用奥林巴斯半硬性输尿管镜（F8/9.8 Olympus）及软性输尿管镜（F5.3/8.4 Olympus URF-P5）行经前列腺小囊的精囊镜手术治疗。结果 23例患者均顺利完成手术,手术时间21-65 min,平均时间（35.1±8.2）min。单纯性精囊炎症7例（30.4%）,精囊炎合并前列腺小囊结石5例（21.7%）,合并精囊结石6例（26.1%）,合并前列腺小囊开口狭窄2例（8.7%）,合并射精管瘢痕狭窄2例（8.7%）,合并射精管囊肿1例（4.3%）,均给予相应处理。术后随访6月,1例复发抗炎对症治疗后消失。结论联合应用软性和硬性输尿管镜行精囊镜检查能直视下观察到精囊腔内的情况,有助于明确顽固性血精的病因并进行相关治疗,充分利用了现有设备和成熟的输尿管镜技术,是可行的诊断和治疗顽固性血精的方法。Objective To evaluate the role of trans-utricular seminal vesiculoscopy using flexible combined with rigid ureteroscope in the diagnosis and treatment of persistent hemospermia. Methods A retrospective analysis was conducted on the clinical data of23 cases with persistent hematospermia admitted in Peking University Wu Jieping Urology Center from June 2012 to December2014. After related examinations, trans-utricular seminal vesiculoscopy was performed in all patients by using a F8/9.8 semi-rigid ureteroscope（ Olympus） combined with a F5. 3 / 8. 4 flexible ureteroscope（ Olympus URF- P5）. Results All the 23 patients accomplished the surgery successfully with the average operative duration of（35.1 ±8.2）minutes（ranged from 21 to 65minutes）.Among them, simple seminal vesiculitis was in 7 cases（30.4%）, seminal vesiculitis combined with prostatic utricle calculi in 5cases（21.7%）, combined with seminal vesicle stone in 6 cases（26.1%）, combined with narrow opening of prostatic utricle in 2 case（8.7%）, combined with scar stricture in ejaculatory ducts in 2 cases（8.7%）, combined with ejaculatory duct cyst in 1 case（4.3%）.All cases were given corresponding treatment during the surgery and followed up for 6 months after the operation.Hematospermia was recurred in 1 patient, and disappeared after anti-inflammatory treatment. Conclusion Flexible combined with rigid ureteroscope for trans-utricular seminal vesiculoscopy is a feasible diagnostic and treatment method for persistent hemospermia, it makes full use of existing equipment and the mature ureteroscopy technique, and can observe the status of seminal vesicle lumen,and is conducive to determining the pathogeny and relative treatment.

关 键 词：软输尿管镜检查 硬输尿管镜检查 精囊镜检查 血精症 

分 类 号：R4[医药卫生—临床医学]